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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493205
Report Date: 11/06/2023
Date Signed: 11/06/2023 04:41:45 PM

Document Has Been Signed on 11/06/2023 04:41 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:MONTENEGRO & CASTRO FAMILY CHILD CAREFACILITY NUMBER:
197493205
ADMINISTRATOR:MONTENEGRO, ANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 712-0725
CITY:LAWNDALESTATE: CAZIP CODE:
90260
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
11/06/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:07 AM
MET WITH:Maria Castro, Co-licenseeTIME COMPLETED:
12:55 PM
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On 11/06/2023 Licensing Program Analys (LPA) Cristina Castellanos and Judy Laureano conducted an unannounced Annual Required Inspection at the above-mentioned facility. LPAs were greeted by Assistant J. Cortez. Present during today’s inspection was co-licensee M. Castro, who arrived later on and assistant J. Cortez.

The hours of operation are Monday through Friday 7:30am to 5:00pm. LPAs toured the home inside and outside. Currently the facility is available to take children from 3 months to 6 years old. Facility is licensed for a Large Family Child Care license with a max capacity of 14 children. Licensee does not provide overnight care. Currently living in the home is co-licensee A. Montenegro.

This is a single-family home with 3 bedrooms, 2 bathrooms, living room, a kitchen/dining room and a detached garage. Families enter the home through the main entrance and the kitchen/dining room is used as a walkway to the backyard. Licensee confirmed child care is conducted primarily in the living room and bedroom no. 1. Per licensee the living room and bedroom no. 1 are used for napping. The living room is used for eating. The primary bathroom the children use is adjacent to bedroom no. 1.

Licensee confirmed the following areas as OFF LIMITS: bedrooms 2, 3, kitchen/dining room and the 2nd bathroom. LPAs reminded licensees that any area designated as OFF LIMITS should be made inaccessible during the hours of operation and/or while children are present.

There are no firearms or ammunition on the premises. Detergents and cleaning compounds are kept underneath the kitchen skin cabinet and the 2nd bathroom. LPAs observed a screened/barricaded open face heater in the main living room. Licensee confirmed that home is available to take in a child that might need medication. Currently there are no children that required medication.

LPAs observed licensee test the carbon monoxide and smoke detectors in the home. LPAs observed a working fire extinguisher in the living room and another one in-between bedrooms 2 and 3.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Cristina Castellanos
LICENSING EVALUATOR SIGNATURE: DATE: 11/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/06/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MONTENEGRO & CASTRO FAMILY CHILD CARE
FACILITY NUMBER: 197493205
VISIT DATE: 11/06/2023
NARRATIVE
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LPAs reminded licensee to maintain proof of an annual service for the fire extinguisher. Licensee confirmed that home provides meals. LPA discussed the importance of maintaining a system where allergies and food restrictions are noted.

Adequate heating and ventilation for safety and comfort were observed in the space. Safe toys and play equipment were observed. The home has a working telephone service and LPAs confirmed the phone number 323-712-0725.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. Prohibited items in Family Child Care Home flyer was provided.

Capacity as specified on the license is being maintained during today’s inspection. Co-licensees were not present when LPAs initiated inspection.

Safe Sleep regulations were discussed due to program being available for infant care. There is one crib or play yard for each infant in care, cribs and play yards are kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. Provider physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Infants up to 12 months of age are placed on their backs for sleeping. Individual Infant Sleeping Plan was discussed and LIC form was reviewed.

Mandated Reporter Training was not available for review. Pediatric CPR/Pediatric First Aid was taken 09/20/2022 by licensees. LPAs reminded licensee the importance of making sure all vendors providing Pediatric CPR and Pediatric First Aid need to be EMSA approved. LPAs reviewed 5 children’s files and observed files to be complete. LPA provided licensees with a current copy of the LIC 311D and LIC126 to use as a reference when auditing files. A sample packet was provided to licensee.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Cristina Castellanos
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2023
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC RO, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MONTENEGRO & CASTRO FAMILY CHILD CARE
FACILITY NUMBER: 197493205
VISIT DATE: 11/06/2023
NARRATIVE
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If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Family Child Care Home Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPAs discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee, M. Castro, was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with M. Castro.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Cristina Castellanos
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/06/2023 04:41 PM - It Cannot Be Edited


Created By: Cristina Castellanos On 11/06/2023 at 11:38 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MONTENEGRO & CASTRO FAMILY CHILD CARE
FACILITY NUMBER: 197493205

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/06/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102425(a)(3)
Infant Safe Sleep
(a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard. (3) Mattresses shall be firm and covered with a fitted sheet that is appropriate to the mattress size, fits tightly on the mattress, and overlaps the underside of the mattress so it cannot be dislodged.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in 1 out of 4 crib mattress was dislodged while infant was asleep, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 11/20/2023
Plan of Correction
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Licensee agrees to have the correct size mattress and/or replace current. Licensee will submit proof to LPA via email.
Type A
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above, assistant did not have valid certification while providing care and supervison for all 6 children in care by herself, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 11/20/2023
Plan of Correction
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Licensee agrees to have assistant complete training and submit certification via email to LPA.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claudia Escobedo
LICENSING EVALUATOR NAME:Cristina Castellanos
LICENSING EVALUATOR SIGNATURE:
DATE: 11/06/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/06/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/06/2023 04:41 PM - It Cannot Be Edited


Created By: Cristina Castellanos On 11/06/2023 at 11:38 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MONTENEGRO & CASTRO FAMILY CHILD CARE
FACILITY NUMBER: 197493205

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/06/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above, cleaning compounds underneath the kitchen sink cabinet were not secured with safety latch, which poses/posed a potential health, safety or personal rights risk to persons in care. Gated kitchen is used as a walkway to access the backyard.
POC Due Date: 11/06/2023
Plan of Correction
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Licensee agrees to have cabinet secured with safety latch at all times. Correction was completed before the end of the inspection..
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 3 out of 3 personnel files did not have completed training, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/20/2023
Plan of Correction
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Licensee agrees to complete Mandated Reporter Training for all staff.
www.mandatedreporterca.com
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claudia Escobedo
LICENSING EVALUATOR NAME:Cristina Castellanos
LICENSING EVALUATOR SIGNATURE:
DATE: 11/06/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/06/2023


LIC809 (FAS) - (06/04)
Page: 5 of 8
Document Has Been Signed on 11/06/2023 04:41 PM - It Cannot Be Edited


Created By: Cristina Castellanos On 11/06/2023 at 11:38 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MONTENEGRO & CASTRO FAMILY CHILD CARE
FACILITY NUMBER: 197493205

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/06/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.2(a)(2)
Reporting Requirements
(a) The licensee shall report the following information the Department by telephone or fax within the Department's next business day and during normal working hours (8am to 5pm). (2) Any change in household composition including adults moving in or out of the home and anyone living in the home who reaches his or her 18th birthday.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above, co-licensee moved out of the home two months ago, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/13/2023
Plan of Correction
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Licensee agrees to notify LPA of moving back and/or updating LIC279 via telephone. Declaration will be submitted of final resolution.
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 1 out of 3, proof of immunization record, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/20/2023
Plan of Correction
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Licensee agrees to provide LPA with proof of imminuzation record via email.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Claudia Escobedo
LICENSING EVALUATOR NAME:Cristina Castellanos
LICENSING EVALUATOR SIGNATURE:
DATE: 11/06/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/06/2023


LIC809 (FAS) - (06/04)
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